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410 Statement of Organization Recipient Committee – Initial Not Yet Qualified Stamped by SOSr~~ /L/50210 Statement of Organization Recipient Committee Statement Type , .... ~-,n-it-ia-1 -------.1---------.,------------11 D Amendment D Termination -See Part 5 121 Not yet qualified or D Date qualification threshold met I Date qualification threshold met Date of termination __ / _ _,, NAME OF COMMITTEE NAME OF TREASURER L,W\j Ch_ouJ JoY G_Fy/-ino C,4:J G:<tme,i I 2.o22 Nicole Woon STREET ADDRESS (NO P,O, BOX) '"''"'"F-ll""~~am;i-.~,,.,.,~ {l:v-C.:~ v Ci..i /~1'4 LJ -, ' n the office of the Secreia Rtt' , of the State of C?Jlff1 20380 Stevens Creek BLVD, Apt 312 STREET ADDRESS (NO P.0, BOX) CITY STATE ZIP CODE AREA CODE/PHONE 10175 McLaren PL Cupertino CA 95014 408-784-0053 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 408-218-7125 FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE Liang4CupertinoCouncil@gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) Santa Clara Cupertino Chao, Liangfang STREET ADDRESS (NO P,O, BOX) 10175 McLaren PL Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 408-218-7125 I have used all reasonable dflfgenc:e in pre-paring this statement and to the best of my knowledge the information contafnedherein-is frueand-complete. 1 certify under penalty of perjury under the laws of the State of California that the fore Executed on 7/15/ L--0£'Z--By c I r·rt< DATE } .,1 J "-J --·-·· ·-· •--,.._ ---• ,., ·---,.._ • ,..,.,,. __ ··----• -· ·---· Executed on ZI I > liA> 2--~By I / y \ I -c:=:, --::::::: DATE CJ , Executed on DATE By -----------=s1"G"'N"A"Tu=RE"""o"F"c"o"N"TR""o""L"L"'1N"'G"""o"F"'F1"c"'EH"'o""L"D"E"R-. c"A"N"'D"'1"D"'A"TE"","'o"R"'s"T"'AT"'E""M"""E-As"u"'R'"E'"P'"R"'o"'p"'o-N"'E-N"'T ___________ _ Executed on DATE By-----------------------------------------SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Advice: FPPC Form 410 {August/2018) (866/275-3772) Statement c;>f Organization Recipient Committee CALIFORNIA 410 FORM Page2 COMMITTEE NAME 1.D. NUMBER Liang Chao for Cupertino City Council 2022 . All committees must list the financial institution where the campaign bank account is located . NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Controlled Committee • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE Nonpartisan Chao, Liangfang Cupertino City Council 2022 ✓ Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) IF A RECALL, STATE "RECALL:' IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE($) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) FPPC Advice: Partisan Partisan (list political party below) (list political party below) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (August/2018) (866/275-3772) ----------------------Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Liang Chao for Cupertino City Council 2022 General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME Of SPONSOR INDUSTRY GROUP OR AFFILIATION Of SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE Small Contributor Committee □----1 Date qualified • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. CALIFORNIA 410 FORM 1.O:NUMBER AREA CODE/PHONE There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 -89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Advice: FPPC Form 410 (August/2018) (866/275-3772)